Provider Demographics
NPI:1740908649
Name:BLANKENSHIP, LAUREN JULIA (DNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JULIA
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN-BC
Mailing Address - Street 1:10533 108TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4030
Mailing Address - Country:US
Mailing Address - Phone:321-432-2829
Mailing Address - Fax:
Practice Address - Street 1:1132 N CHURCH ST STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1040
Practice Address - Country:US
Practice Address - Phone:336-398-3988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9444447163W00000X
NC5016743363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse